The Zika Crisis
Latest Findings

Summary

THE ZIKA CRISIS: Latest Findings

Presented in Collaboration with Reuters
The ongoing spread of the Zika virus — and its unconfirmed potential links to a birth defect called microcephaly — have raised worldwide alarms. This Forum examined what we know and don’t know about the virus, drawing parallels and lessons from another disease outbreak, Ebola, that we can apply to the Zika emergency. An expert panel discussed the current status of our understanding of the Zika virus and its health effects; containment strategies.

Brief Video Highlight

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Presented in Collaboration with Reuters

Background Articles

Image Credit: Reuters Pictures/ Mariana Bazo

  • The Forum Moderator

    Thank you all for joining us today. We will begin in about 10 minutes at 12:30pmET.

  • The Forum Moderator

    We”ll be starting in about 5 minutes.

  • The Forum Moderator

    We’ll be starting shortly. Thank you all for joining us today.

  • The Forum Moderator

    We are beginning.

  • The Forum Moderator

    Welcome all. This event is in collaboration with Reuters.

  • Video is not loading

    • The Forum Moderator

      Thanks. Try refreshing your screen. If you still have trouble, try Chrome or Safari.

  • The Forum Moderator

    This clip is courtesy of Reuters.

  • The Forum Moderator

    Dr. Fauci is joining us remotely from the NIH.

  • The Forum Moderator

    The CDC Zika recommendations for pregnant women are here: http://www.cdc.gov/zika/pregnancy/

  • The Forum Moderator

    Dr. Fauci wrote a Perspective in NEJM about Zika here: http://www.nejm.org/doi/full/10.1056/NEJMp1600297

  • The Forum Moderator

    More here about the new study pointing to Zika killing developing brain cells: http://www.sciencemag.org/news/2016/03/zika-virus-kills-developing-brain-cells

  • The Forum Moderator

    Dr. Jha was part of a group that analyzed the global response to Ebola. He believes that there are lessons from that response that can be applied to the Zika response. More about the Ebola response can be read here: http://news.harvard.edu/gazette/story/2015/11/an-indictment-of-ebola-response/

  • Barry Needalman

    Is there an estimate of the percentage of infected, pregnant women have adverse effects?

    • The Forum Moderator

      Thank you for your question. I’ve passed it along.

  • The Forum Moderator

    This clip is from Reuters.

  • The Forum Moderator

    We will have a Q&A towards the end of this discussion. If you have a question for the panelists, post them here or email them to theforum@hsph.harvard.edu.

  • Maria Cláudia Stockler

    YF Vaccine and cross reaction with ZIKV?

    • The Forum Moderator

      Thank you for the question!

  • Elisabeth

    I’m curious about lack of discussion and lack of media reports re: Haiti.

    • The Forum Moderator

      Thank you!

  • Elisabeth

    How far along is evidence that prior dengue infection possibly causing more severe reaction leading to congenital microcephaly and or Guillain-Barré?

  • The Forum Moderator

    Thank you all for your questions! I am passing them along for our Q&A and we’ll get to as many as we can.

  • The Forum Moderator

    We will be posting the full-length video on this site early next week. We also will post the video on YouTube and iTunesU, and we will also post the audio on this site, iTunesU and SoundCloud.

  • Cristina Munk

    If we are able to develop a vaccine, what needs to be done to ensure that it’s made available at affordable prices, particularly in countries like Haiti?

  • Dr. Kenneth Onyedibe

    Hi all, joining from Nigeria. Same thoughts as Cristina

  • Crusauvage

    Please elaborate on the connection to Guillain Bare Syndrome. This condition would apply more to the general population than pregnant women and their fetus.

  • Maria Cláudia Stockler

    The impact of mosquito protection: repellents (Icaridene/ DEET 20%/ IR3535), Bed nets/ Clothes with Permetrina – not available, and when available not affordable FOR THE POOR.

  • Stephanie Ocko

    There was a lot in the press about genetic alteration of aedes aegypti — can you comment?

  • The Forum Moderator

    Our Q&A has begun. Thank you all for asking your questions. We will ask as many as we can in the time remaining.

  • The Forum Moderator

    We will be wrapping up soon. Just a reminder that we will post the full-length video on this site early next week. We also will post the video on YouTube and iTunesU, and we will also post the audio on this site, iTunesU and SoundCloud.

  • Walter Ramos

    Hi, will there be a recording of the forum afterwards for the public? Thanks.

    • The Forum Moderator

      Yes, we will post the video and an mp3 file on this page early next week

  • The Forum Moderator

    We will ask our panelists to login and answer questions on this chat later.

  • Kristen Lally

    Question from email

    What do you think are the reasons for the outbreak of Zika virus

    Thanks

    Best regards
    Dr Anil Makkapati

  • Kristen Lally

    Question from email

    After Zika virus infection, how long does the immunity last? Are there different serotypes for Zika like Dengue?

    Thank you

    Marguerite A. Erme, DO, MPH

  • Kristen Lally

    Question from email

    I realize you’re not entomologists, but how likely is it that species besides a. aegypti are playing a role spreading Zika? It would have big implications for control, wouldn’t it?

  • Kristen Lally

    Question from email

    Is the virus in urine samples as well as blood samples, if so, doesn’t it last longer in urine and enable better diagnostic options? Are public health officials storing and testing urine samples?

  • Kristen Lally

    Question from email

    Does the mosquito itself get affected by the virus before biting any human host or is it rendered harmless?

  • Kristen Lally

    Question from email

    Hello I’m Shreya Tapaswi from India.My question to the panelists is as follows:

    If Aedes mosquito is the vector of the Zika virus , could you speculate which organism can be the possible reservoir of the virus? Between two successive outbreaks where does this virus go to hiding? Are tropical & equatorial areas more prone to this virus?

  • Kristen Lally

    Question from email

    “Fish Against Zika.” That’s the title of CNN’s recent video explaining how fish could become potential “allies” in our fight against the Zika virus, according to researchers in El Salvador.What do you know about biological control of Zika?

    Thanks, Tamara

    Tamara Awerbuch Friedlander, M.Sc., Ph.D.

  • Kristen Lally

    Question from email

    How does the zika virus affect people who already have auto immune diseases or chronic auto immune issues? Such as hashimoto thyroiditis, chronic fatigue or fibromyalgia.

  • Kristen Lally

    Question from email

    Good afternoon!

    my name is Giorgia Argentini, I am a MD working and living in Brasil,Rio de Janeiro

    My questions are:

    -Knowing that Zika virus caused already some small epidemics in the past 40 years in several countries all over the world:

    1. is this the 1st time that the epidemic reached this dimension and why?

    2. it has never been seen in previous outbreaks a correlation with microcephaly?why?

    -given the high numbers of cases of dengue in the past year in brasil, mostly in the same area, north east of the country:

    1.why WHO declared emergency for ZIKA and not for the 200%incrementation of dengue cases?

    2.is it possible that a previous or concurrent dengue infection in pregnant women caused the mycrocephaly if infected by zika during pregnancy?

    -what is true and is false about all rumors heard about MONSANTO use of agrotoxic substancies in the area? and any other rumor about other possible causes of microcephaly?

    -how will it be justified that if now a vaccine or remedy for ZIKA is found, it was not possible to pursue it as fast for dengue in the past years even if studies and researches we were much more extended and funded?

    -what should a GP tell his/her patients without alarming but still protecting them? to both: women and men, of any age!

    thanks

    look forward to assist the conference and hearing the different doubts all over the wordl!

    sincerely

    Giorgia

  • Kristen Lally

    Question from email

    What states have confirmed Zika cases at this point? Here in New England we’ve just had another one diagnosed, I think there have been 3 total. What can we expect as the weather gets warmer, too, spring is just around the corner?

  • Kristen Lally

    Question from email

    Zika has been known since 1947 and there have been several large outbreaks. Why hasn’t there been more research on a vaccine since then, or even the creation of a standard diagnostic test? These are symptoms of the flaws in our global surveillance and research systems. What are your recommendations for better tracking and reacting to these types of outbreaks, which only are going to increase with global warming?

  • Kristen Lally

    Question from email

    The WHO, CDC and other organizations seem to be mobilizing much more effectively around Zika than they did around Ebola. The WHO declared an emergency last month before the link with microcephaly was fully verified – I think that’s a first for them. And the CDC also has sprung into action around surveillance. Do you think this escalating response is a direct result of the lessons learned from Ebola?

    • Jill Glasspool Malone, PhD

      This is partly because the Zika Response Working Group has been pushing, pushing, pushing. Members of our group were involved in Ebola and have been determined, since December to not let an infectious disease outbreak play out like that again. We have been writing, talking behind the scenes, in contact with journalists, the WHO, BARDA, DTRA, DoD. But the USG has not learned a lesson. The CDC is getting prepared but there is NO money. None. A lot of talk, but no $$$ to do anything yet. Furthermore, the NIH and most of the USG is all about vaccines. Vaccines are not going to work for this. Time is too short and this virus is not a safe candidate for a vaccine (think about the mechanisms of action of GBS as well as epitope mimicry issues).

  • Kristen Lally

    Question from email

    Brazil is expecting hundreds of thousands of tourists for the Olympic games this summer. Might this be a reason why the international community is responding more rapidly? If this outbreak was happening in Africa, would the response be the same, do you think?

  • Kristen Lally

    Question from email

    I think that the recommendations in some Latin American countries for women to avoid pregnancies are simply irresponsible, given that there are so many unplanned pregnancies in these countries due to the lack of reproductive health resources not to mention access to abortion. You’ve talked a bit about this, but what can we do at the policy level to discourage these recommendations and advocate for more access to contraception services in areas where Zika is present?

  • Kristen Lally

    Question from email

    If you do contract Zika and you’re not pregnant, how long do you realistically have to plan to avoid pregnancy? I read that Zika is clear from the blood of an infected woman after a week or so. But, in El Salvador, the government told women to refrain from pregnancy for up to 2 years.

  • Kristen Lally

    Question from email

    Since asymptomatic mothers can pass on Zika to their unborn children, how can we fully screen for this in pregnant women? 80% of those who get the virus don’t feel ill or have symptoms. How is it possible to screen every pregnant woman who is in a Zika-affected area?

  • Jill Glasspool Malone, PhD

    Robert W Malone, MD of Atheric Pharmaceutical is at the World Health Organization this week presenting what could be the most clinically important drug candidates to combat the Zika Virus. They could be in clinical trials extremely rapidly, if they had investment or non-dilutive capital. The world sleeps, while there is a solution.
    Atheric Pharmaceutical LLC (“Atheric(tm)”) is a biopharmaceutical company focused on the rapid development and commercialization of re-purposed drugs to prevent and treat Zika and other Flavivirus disease. Atheric(tm)’s lead drug products are reformulated broad spectrum 4-Aminoquinoline-class antiviral drugs that inhibit autophagy-dependent viral replication. Atheric is committed to providing broad-spectrum medical countermeasures for Zika and other neglected tropical diseases.
    ANTI-VIRAL ZIKA VIRUS DRUGS
    Zika outbreak medical countermeasure (MCM) strategies have been identified, with the most promising MCM available for expedited clinical testing identified being re-purposed anti-malarial drugs Of these, the most suitable for immediate clinical testing for use in protecting against the Zika Virus infection; to prevent development of Zika Virus fetal syndrome and GBS have been identified. Provisional patents covering the used of these compounds for Zika and other Flaviviruses have been filed with the US Patent and Trademark Office. Clinical trials to determine correct dosing and proprietary formulations appropriate for the indicated therapies are being rapidly developed. Regulatory discussions with FDA have been initiated.
    Zika virus has been postulated as playing a key role in the pathogenesis of Zika-associated primary microcephaly and GBS. The anti-malarial drugs under pending patents are autophagy inhibitors, and in vitro testing has demonstrated efficacy. Of interest is that these drugs have been safely used during pregnancy, and cross the placenta enabling clinically significant pharmacodistribution to both mother and fetus. Systemic literature review with meta- analysis indicates that prenatal exposure to these drugs during maternal autoimmune disease treatment does not appear to increase the risk of adverse pregnancy outcomes, except those associated with the underlying disease.